Virginia Gov. Terry McAuliffe gestures during a news conference at the Patrick Henry Building in Richmond, Va., on Monday. (Bob Brown/AP)

Virginia’s on-again, off-again special session got rolling again Tuesday, as hundreds of lobbyists and activists on opposite sides of the state’s Medicaid battle crammed into a Senate hearing on whether to expand the program through the state budget.

The hearing was the first sign of life from the Senate since last week, when the chamber went home one day into the special budget session, leaving the House and its two-year, $96 billion spending plan hanging.

But the Senate Finance Committee hearing did little to bring the two chambers any closer to resolving an impasse over whether to expand Medicaid under the federal Affordable Care Act. The stalemate threatens to shut down state government if it is not resolved by the start of the new fiscal year, July 1.

The General Assembly is more than three weeks past its original March 8 deadline for passing a budget, and the delay is bringing new pressures to bear on legislators. The time off has given both sides the chance to whip up support on the local level, including hospitals that want the Medicaid money and local governments and schools that need a state budget in place before they can finalize their own spending plans. On Tuesday alone, Gov. Terry McAuliffe (D) traveled to two health-care centers in Hampton Roads to make his case for expansion.

But rather than buckle under the pressure, the two sides seem to be lurching even further apart, with rhetoric amped up to levels not seen since last fall’s governor’s race.

“We won’t vote for a budget — I can’t be emphatic enough — nor will the governor sign a budget that doesn’t have some form of expansion,” Senate Majority Leader Richard L. Saslaw (D-Fairfax) said Friday in a conference call with reporters.

McAuliffe had made the same vow during the governor’s race. But he softened his campaign rhetoric after Republicans said the promise amounted to a threat to shut down the government over Medicaid.

Asked whether Saslaw had accurately characterized the governor’s position, McAuliffe spokesman Brian Coy did not answer directly. But he suggested that any shutdown would be the fault of Republican delegates and House Speaker William J. Howell (R-Stafford).

McAuliffe “remains confident that his proposal is a foundation for the General Assembly to come together and pass a budget that keeps people healthy and grows our economy,” Coy said. “Unfortunately, that cannot happen until Speaker Howell and House Republicans offer a meaningful proposal to put Virginia families ahead of partisan politics.”

A group that called itself Concerned Citizens of the Commonwealth appeared at Howell’s office bearing five oversized $1 million bills emblazoned with the speaker’s face. The bills were meant to represent the $5 million a day the federal government is promising Virginia if it expands Medicaid.

Howell and House Republican leaders, meanwhile, began the day by issuing a news release that accused McAuliffe and other Democrats of “pressuring people” into supporting expansion. They pointed in part to an episode from the General Assembly session when Del. Riley E. Ingram (R-Hopewell) said McAuliffe threatened a biofuels project in his economically distressed district if he did not vote for Medicaid expansion. McAuliffe’s office denied that account at the time.

“The speaker and other House leaders have expressed ample willingness to debate Obamacare’s Medicaid expansion after the General Assembly completes work on the state budget,” said Howell spokesman Matthew Moran. “The only thing standing in the way is the governor’s insistence on bringing Obamacare to Virginia.”

McAuliffe, Senate Democrats and three Republicans in the evenly split chamber want to expand Medicaid under the Affordable Care Act, saying it would provide health care to 400,000 needy Virginians and create 30,000 jobs. Republicans in the GOP-dominated House say the federal government cannot afford to make good on its promise to pay most of the $2 billion-a-year bill.

McAuliffe tried to reframe the debate last week by proposing his own budget plan that called for expanding Medicaid for two years as a pilot program. That plan differed substantially from the “private option” proposal that expansion supporters had worked from all session. That plan, called Marketplace Virginia, would have used federal Medicaid money to buy private insurance for enrollees.

The move won McAuliffe new supporters, cost him others and led to more delays. It earned him ardent fans beyond the health-care industry because it sprinkled $225 million in projected Medicaid savings on teachers, state employees, university professors and others. It cost him the backing of the Virginia Chamber of Commerce, which had backed the marketplace approach.

The Senate voted last week to adjourn until April 7 so its members could study McAuliffe’s budget and receive public input. Tuesday’s Finance Committee hearing provided the opportunity for the public to chime in. With some sporting a doctor’s lab coat and a chemotherapy patient’s head scarf, purple “Close the Coverage Gap” lapel stickers or green Americans for Prosperity T-shirts, they lined up to testify for and against.

Teresa A. Sullivan, president of the University of Virginia, testified that the 2 percent raise in McAuliffe’s budget would help the school attract and retain faculty and staff members

W. Sheppard Miller III, a Hampton Roads businessman, was one of several speakers who urged the committee to support Marketplace Virginia, not the straightforward Medicaid expansion that McAuliffe is urging.

“I’m not a fan of expanding Medicaid here,” Miller said.

Opponents noted the Affordable Car Act’s many troubles as they cautioned against expansion.

“Do we really believe Washington is going to keep its promise?” said Nicole Riley, Virginia state director of the National Federation of Independent Business. “This is a complex issue that should not be rushed.”